SUN WON D.D.S - NPI 1689456105 - Dentist in Haltom City, TX

Q: What is Sun Won's NPI number?

The NPI number for Sun Won is 1689456105. It was assigned to this individual provider in the NPPES registry on October 18, 2023.

Q: What is Sun Won's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Sun Won was last updated on November 30, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Sun Won D.d.s NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUN WON D.D.S (NPI 1689456105) is an individual general practice provider in Haltom City, Texas, licensed in California (109566) and active in the NPI registry since October 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689456105

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameSUN WONCredential: D.D.S

Location Address5190 WESTERN CENTER BLVDHaltom City, TX 76137-2144

Mailing Address4515 Fermi Pl Ste 106Davis, CA 95618-9411

Phone(817) 656-1215

Sole ProprietorYes

Enumeration DateOctober 18, 2023

Last NPPES UpdateNovember 30, 20252 updates tracked since enumeration

NPPES CertifiedNovember 30, 2025

✔ NPI 1689456105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CA · 109566

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

5190 WESTERN CENTER BLVD, Haltom City, TX 76137

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sun Won D.d.s is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76137 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.20 typical visit price

range $56.47 – $171.07

Typical copayment $21.80 (range $14.11 – $42.76)

Most-billed visit code 99203

Established Patient

$70.45 typical visit price

range $18.18 – $139.68

Typical copayment $17.61 (range $4.54 – $34.92)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMANA SABIR DDS

Dentist (General Practice)